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Table 1 Advantages and disadvantages

From: Anterior subcutaneous internal fixation for treatment of unstable pelvic fractures



Minimally-invasive approach with minimal soft tissue damage

Danger of injury to the A./V. epigastrica superficialis and A./V. circumflexa ilium superficialis

No extensive soft tissue dissection necessary

Danger of perforation of the abdominal muscles and urinary bladder

Short operation time (average total duration of procedure 30-45 min)

Decreased stability compared to open reduction and plate fixation in pure open-book injuries

Immediate postoperative mobilisation

Possibly interposed soft tissue within the fracture site cannot be removed

No contact with other surgical wounds

Fracture fragments causing neural or organ compression cannot be removed

No open pin tracts compared to the external fixateur

Implant removal always in operative theatre (compared to external fixateur)

Minimal blood loss


No restrictions regarding patient anatomy; easy use even in morbidly obese patients


No communication of implants with intra-abdominal compartment


Biomechanically proven superior stability compared to external fixateur [20]


Further diagnostics such as computed tomography are not interfered with


Reversible procedure: Salvage procedures are still available